Diathermic electrode



June 28 1927. 1,633,649

M. STERN DIATHERMIC ELECTRODE Filed Jan. l2. 1926 INVENTOR Maximilian Sfern BY Wm his ATTORN Patented June 28, 1927.

UNITED STATES MAXIMILIAN STERN, OF NEW YORK, N. Y.

DIATHERMIC ELECTRODE.

Application filed January My present invention relates generally to clr-ctro surgical instruments, and has particular reference to an electrode for the appli- 'itf ir n of diathermy to an interior organ.

in the application of diathermy to organs of the body which are relatively inaccessible, such as organs in the nature of the prostate gland, instruments of the character hereto t'ore utilized have presented grave technical dilliculties and have entailed numerous dis- :nlvant; which have rendered the proper diathernnc application extremely difficult and impractical, if at all possible.

it is among the more important objects of the present invention to provide an instrumcnt which may be utilized for purposes of this character, and although my invention contemplates a primary purpose in providing a diathcrmic electrode for application in the treatment; of senile hypertrophy of the prostate, nevertheless the features of my invention will be readily applicable to moditied forms of instrimients of great variety designed for a wide range of applicability.

My invention contemplates the application of an electrode to an internal or inaccessible organ by an insertion of the instrument through a body cavity; and more particularly, one embodiment of my invention ronlettiplntos the provision of an instrument which is designed and adapted to be applied pcr rectum to the prostate and the seminal vesicles.

An object of the invention is to provide an instrimient which is constructed and arranged to permit adjustment thereof to facilitate in crtion and removal with respect to a body cavity, and to render accidental displacement or removal, after a proper adjustment has been made, improbable and almost impossible.

A feature of my invention lies in providinn an electrode surface or portion which is collapsible to facilitate insertion and removal. and which when uncollapsed prewents a predeteri'nined contact. area of increased size and of a shape and disposition with respect to the rest of the instrument which prevents slipping or accidental expulsion from the cavity.

Another feature of the invention lies in providing means for controlling the adjustments of the electrode portion from an exposed and easily accessible portion of the instrument.

12, 1926. Serial No. 80.720.

Another feature lies in constructing this control means in a manner which will indi rate to the operator the relative adjustment of the contact portion which is disposed within the cavity.

in a preferred embodiment, the contact portion comprises a pair of members or sections which are relatively foldable like the covers of a book and which are con. tructed and arranged to present and provide a compact portion capable of easy insertion and withdrawal when folded, and which in unfolded or uncollapsed positions will present a contact portion having a predetermined configuration and disposition. in the embodiment herein described and illustrated, the contact members or sections are shaped to provide an uncollapsed electrode portion having a configuration which conforms substantially to the seminal vesicles when the instrument is applied through the anus into adjacent position with respect thereto.

A preferred embodiment contemplates the mounting of these members or sections upon the ends of closely positioned parallel spiir dles which extend outwardly through a body portion and are provided with manually controllable means at their free ends for causing rotation of the spindles and consequent adjustment of the contact members.

Another feature of the invention lies in designing and constructing the instrument with particular reference to the distribution and Weight thereof so that the instrument Will be self-supporting after it has been prop erly applied. More particularly, it is a feature of the invention to position the center of gravity toward the outer free end of the instrument, as by weighting the outer end of the body portion of the embodiment hereinbefore referred to. In this manner an instrument of the character herein described for application to the seminal vesicles may be rendered self-supporting when the patient is in the dorsal position, as will appear more fully hereinafter.

It is a further feature of the invention to provide electrical connecting means in an easily accessible manner, whereby one terminal of a proper electric circuit may be associated with the contact portion. And another feature lies in providing means for preventing short-circuiting of the instrument if the operation is performed upon a metal table.

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ii -t llO For the attainment of the foregoing objects and such other objects as may hereinafter appear or be pointed out, I have illustrated one form of my invention, via, one embodiment of a prostatic electrode, in the accoinpai'iying drawings, in which- Fig. 1 is a side elevational view of the in strument, with the contact portion in col lapsed position;

Fig. 2 is an end elevational view taken from the forward portion of the instrument, and showing in dotted lines the positions a sumed by the contact members after a certain adjustment has been made;

Fig, 3 is an end elevational view looking forwardly of the instrument from the rear or control end;

Fig. 4 is a plan View, shown partly in section, taken substai'rtially along the line 4 l of Fig. 1 and showing the contact portion in uncollapsed position; and

Fig. 5 is a croz s-scctional view taken along the line 5 5 of Fig. 4, showing a detail of construction.

Referring to the drawings, and particularly to Fig. 1, it will be observed that I have shown an elongated, preferably cylindrical body portion within which a con tact portion 11 is mounted to project or extend forwardly of the body portion it). The contact portion it may comprise a pair of contact members or sections [2 and til (Figs. 3. and 4), each of which comprises a substantially straight rear edge 14, an out- \vardly curved semi-circular end portion 15, an outer edge 16 substantially parallel to the edge 14, and a rear inwardly curved outer edge portion 17. The members l2 and 13 are arranged to be relatively adjustable, in a manner whereby the members t2 and i2; may be ln'ought'into superposition (Figs. 1

and 2), or into uncollapscd positions within a single plane (Fig; l), the adjustability being preferably accomplished by making the member: foldable and collalriblt like the covers of a book about a hinge axis conforminp substantially to the abutting inner edges 14.

For the purpose of ontrolling this rein-- tive adjustment ofthe contact members, i prefer to mount them upon rearwardly extending spindles 15% or 19 respectively, the spindles being mounted in cloely parallel positions, extending longitudinally through the body portions it). and mounted therein for rotation of each thereof about its axis. The spindles t8 and 19 are preferably of a width no greater than the width of the memhers 12 or 13, and are associated with the latterin a manner whereby the edges 14 will form a substantially straight continuation thereof.

For the purpose of preventing the spindles l8 and 19 from riding" upon each other, I prefer to mount them within a sleeve casing 0r bearing 20 carried by the body portion 10. Adjacent their rear or free ends, the spindles carry spur gears 21 or 22 respectively, these gears being of a size to permit them to mesh whereby rotation of one shaft will cause simultaneous rotation of the other. At their extreme ends, I prefer to provide the spindles with manually controllable means such as the grips 23 and 24 respectively, the latter comprising transverse pins threaded into or otherwise suitably associated with the spindles. i

Preferably, the gears 21 and 22 are enclosed, and for this purpose, and the additional purpose of properly positioning the center of gravity of the device, I provide a conical end portion 25 for the body portion 10, the portion 25 having an end 26 of slightly i ouced diameter with which a cap 2? may engage. The end 26 is of a longitudinal length much smaller than the length of the cap 27, so thatfa chamber is produced underneath the cap and outside of the portion 26 within which the gears 21 and 22 are accommodated.

Although details of construction are optional, I prefer to construct the body portion it) of a cylindrical piece of insulating material molded about the sleeve bearing 20; and l prefer to extend the sleeve bearing throuyh the conical end 23 so that the latter will be held in abutment with the body portion It) by the inside faces of the gears 21 and 22. The portion 25 prcl'erably made to diverge outwardly toward the free end of the in trument, and is ad\Qintageously made of metgd whereby the proper weight is imparted to that end of the instrument. The outer periphery of the cover 27 is preferably made to constitute a continuation of the conical surface of the portion 25 so that the appearance of the device is not marred but presents a rather pleasing contour as clearly shown in Fig. 1. It will be understood that the end of the cap 27 is provided with parallet bores properly spa ed to permit the spindies 18 and 19 to pais there-through. I als prefer to provide the grips 23 and .34 with end portions whi h are bent outwardly, that is, away from each other, as clearly shown in Figs. 32 and t. so that manipuhitkm thereof will be facilitated. Preferably the grip members 2 3 andil have their inner ends extending outwardly from the spindle-i t8 and 19 in the same directions as the contact members 12 and 31. whereby the positions of the latter willbe evident to the operator by the positions of the grip members 9 and 24.

The metallic end portion with an electr c terminal 28' of any suitable construction or type whereby electrical con-' nection may be established with the end portion from an out ide source. For the purpose of transmitting' this electrical connecis provided rib till

tion to the contact portion at the forward end of the device, the sleeve bearing may be made of metal.

The edges of the contact members 12 and lil are suitably rounded off, and it will be observed upon viewing Fig. 1 that when the members are in superposed or collapsed positions, they provide and present a compact unit. which is easily inserted nto a constrict ed body cavity. In this connection, it will he noted that the semicircular end portions 15 are particularly suitable for easy inscrlion thereof. It is also to be noted that the curved edge portions 17 constitute abutments alter the contact portion has been uncollapsed or unfolded which will prevent; and render dillicult undesired accidental with drawal ot the instrument.

in a preferred method oi tu lisin the instrument, the patient is: caused to assume the dorsal position. the contact portion is inserted with the instrument in a. snbstair tialiy horizontal position, and thereupon the arips 22 and 24 are manipulattal to unfold and uncollapsc the contact portion so as to present, a contact area of increased size and conforming substantially to the seminal ve.;i-

lt will be understood that nstru 'ltf. tilt mcut is inserted no further than to a degree at which the electrodes are totally within the cavity, although the amount of in ertion will depend upon circumstances and retpiircments. lly then releasing the instrument, the out r end thereof will tend to fall bc-l'ause of its weight, and in doing so the forward end, that is, the electrode surface, will be held firm y against the upper wall ol the cavity and against the organs which are being treated. This depression of the outer end. and the formation of an abutment by the edge portions 17 tend to make the instrument entirely self-supportitrn in addition to insuring iii-m and continn d contact ot' the electrodes with the desired organs.

It will be understood that the indifferent: electrode applied to the patients body at any other suitable portion thereof. For the purpose of preventing a short circuit of the electric current in case the operation is being pct-termed upon a metal table, I provide ltgjs it!) carried by the under portion of the conical end 25 and constructed ot insulating material. it the outer end of the inst ruincut should assume a depressed position which causes contact thereof with the table, the legs 29 will be the portions of the instrument which will so contact, and hence no short circuiting will occur.

it; will be obvious that my invention may be applied to modified forms of instrun'ients which may be designed for imilar functions. and I do not mean to limit myself hereby to an electrode for the particular purpo es herein described. It will also be obvious that the contact portion may be rendered collapsible in a variety of ways, and the shape of the electrode sections may be varied to suit requirements. Other changes and alterations in the details herein described and illustrated for the purpose of exydaining the nature of any invention ma ltc mad-e by those slv'illcd in the art w thout departing from the spirit and s ope of the invention as c:-;pre-ccd in the lli)i t'll-.ll'll laims; it is tlictet ore inicndi-d that lll rt lctiils be interpreted as illu tratinand not. in a limiting sense.

What l claim r I. in an electrode of the character described, a pair oi contact numbers \Yitt h are relatively i'oldablc lilnthe, timers ot a book to permit easy insertion thereot into a body avity whcn they are folded.

:3. In an electrode ol the character dc scribed, an elongated body portion, a pair of contact members carried at, one end thereof ll' loldahle like the. covcis f a lrtiol; along an axial line, paid menib having a configuration to provide a rclatlii l v compact mass when folded and to pro vide an increased contacting suri'ace when unfolded.

$2. in an electrode ol' he character dc- :-.-ribcd. an clongatctil body portion, a pair oi contact members carried at one cud lltet'c ot and lelativciy l'oldable lihe. the cottt's of a book alongan axial line, said nit-tubers having a ctndiguration to provide a relic lively compact mass w'ien f-. ltlttl and to provide an increased contacting surface when unfolded. and means associated with the other end of the body portion and opera lively connected with the contact nu-nibers for controlling the folding and unfolding thereof.

-l. In an L Uttl'UtlQ of the cha s-fer scribed, a substantially i'lat contact portion having a substantially U-sl taped pcripheuv and comprising relatively adjustable lo tudinally symmetrical taCCilOllt-l, said lying adjaccnt to each other on either il ot' the axis of symmetry, and menu for ad justing said sections about said :tKis to brine them into sut er-postion whereby insertion and removal of the contact portion with rcspect to a body cavity will be facilitated.

5. An electrode for application to .ho seminal vesicles, comprising a contact portion which is collapsible to facilitate ilk-Pttion thereof into the anus and having! an uncollapsed configuration conforming subsfairially to the area presented thereto by the seminal vesicles.

6. In an electrode of the chaQatter dcscribed. a contact por ion comprising a pair of secti0ns arranged and constructed to be collapsible into compact relation with respect to each other. said sections having. rounded forward and rearward edges which facilitate insertion and removal of the col ll l lapsed contact portion with respect to a body cavity, and said sections having configurations which complement each other to present 0. continuous electrode surface having a U-shaped periphei when the sections are uncollapsed after the insertion has been accomplished.

T. In an electrode of the cln'tracter descrihed, collapsible contact niei'nbcrs adapted to be inserted into a body cavity when col lapsed, and means for nneollapsing said members after insertion thereof to present an incr ased contacting surtace within the cavity, Said mean-1 con'iprieing cooperating spindles carried thereby, and manually operab c means associated tha'ewith tor controlling the cooperation thereof.

8. In an electrode of the thaaicter de scribed, collapsible contact members adapted to be ineerted into a body (1 vit when collapsed, and means for incollapsing said members after ins rtion thereof to present an increased contacting sur'i'ete within th cavit), said means comprising spindles carried by the members. and manually opcr able means carried tlEcUclrV tor cad' rotation thereof.

9. ln an electrode of the chm scribed. an elongated body portioi, tetzti: el v adjustable contact members extending;

tron: one end thereof, 1 5 mean. .or t'\ trolling the adpistment from the oi end thereot, raid means \t'liilPl'LlP-Q' splint s asthe members and extending;

sociated with through and t'otutablj, mounted within the body portion, and neans tor otating sadl spindles.

'10. In a electrode of the character deax-ribed, an elongated body podion, relatiYLl t' adjustable contact member; e Mending? tr" 3 one cnd thereof. and means t'or con inn! the aaljusttneat tron] the other end ice-1. said means comprising: spindl s assoziated with the niel'nbcrs and extending: through and rotatabl mounted within the body portion, and means tor rotating aid pindlce. said last. named meansindoding nirsltilrec t-ar carried by the spindles w rerel t rotation of one :mint lc will cau e rotation i I oi he other.

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lit an t'l tlUtlt ol the charact r l an elongated bod) portion. a coliapsil l contact portion carried at one end thewot'. and mean: tor accomplirahiup the ollap ing and uncollapsiog ol' the latter laid means comprising a double barreled s eeve bearing extending through the bodv portion. a pair of spindles associated with the contact portion and mounted for rotation vithin said bearing, and manual grips carried by the tree ends of said spindles.

In an electrode of the character described, an elongated body portion; a collapsible contact portion carried at one end thereof; means for accomplishing the coll and uncollapsing, said means COM); pi a double barreled metallic sleeve bearing extending through the body portion, ano a pair of spindles associated with the contact portion and mounted tor rotation within said bearing; and means tor e -tablishing electrical *onnection between the tree ead ol' the body portion and the contart portion, said last named means ctnnprisine; a metallic end portion mounted upon said bearing, and an electric terminal arc-,oeiated therewith.

13. In an electrode ot the character described, an eloi'igated bod v portion, and a collapsible contact portion at one end there of adapted to be inserted into a body cavity when H Elapsed, the aseinined electrode beingg' ,:o t esiarntvl h respect to weight distribution as to position the center of ravity thereof ;,ttl lilt7(llt to one end thereof.

il. in an electrode of the cha ttittl' de- 'liliiftl. an elongated body portion. and a collap ible t'illltlltH portion carried at one end Lheicot and adapted to be inserted into a bod}; cavity when collapsed. the oth r end ot' the body portion being weighted to hold he conta t. portion against the upper wall or the cavity.

lo. in an electrode ot' the (ll-starlet de scribed, an elongated bod portion. a co! lapsii )le contact portion carried at one end hereof and adapted to be in led into a bod; cavit) when lUlltllJwttl. 15.91tlil; tor nn collapsing (he contam portion alter the in sci-lion thereof, am. tlll l'rre end of the bad portion bring)" weighted so as to lio o uncollnpsed contactportion against t'ic per wall of the cavity.

ll In an instrunn-nt of the character de scribed, an elongated bodv airfoil. an electrode [jh'llt Uit at one end thereof tor inser tion into a body cavi electrical count lion means at the other end then-oi. said means and electrode portion being in elect rical coormunicat-ion. and in ulatingleg-1 cart-it l by the end of the instrument oppodte the electrode portion. whereby contact between the expeeed portion of the instrnmct'it and a support. will tat-re plac it at all. through "'aitl insulating legs.

in witness whereof. I have signed this specification this 5th day ot .litnuarv, lll'ltl.

MAXmuai-w H'IERN.

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